Rausch Manuel K, Parekh Sapun H, Dortdivanlioglu Berkin, Rosales Adrianne M
Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712, United States of America.
Department of Aerospace Engineering & Engineering Mechanics, University of Texas at Austin, Austin, TX 78712, United States of America.
Prog Biomed Eng (Bristol). 2021 Oct;3(4). doi: 10.1088/2516-1091/ac23a4. Epub 2021 Sep 30.
Excessive bleeding-or hemorrhage-causes millions of civilian and non-civilian casualties every year. Additionally, wound sequelae, such as infections, are a significant source of chronic morbidity, even if the initial bleeding is successfully stopped. To treat acute and chronic wounds, numerous wound healing materials have been identified, tested, and adopted. Among them are topical dressings, such as gauzes, as well as natural and biomimetic materials. However, none of these materials successfully mimic the complex and dynamic properties of the body's own wound healing material: the blood clot. Specifically, blood clots exhibit complex mechanical and biochemical properties that vary across spatial and temporal scales to guide the wound healing response, which make them the ideal wound healing material. In this manuscript, we review blood clots' complex mechanical and biochemical properties, review current wound healing materials, and identify opportunities where new materials can provide additional functionality, with a specific focus on hydrogels. We highlight recent developments in synthetic hydrogels that make them capable of mimicking a larger subset of blood clot features: as plugs and as stimuli for tissue repair. We conclude that future hydrogel materials designed to mimic blood clot biochemistry, mechanics, and architecture can be combined with exciting platelet-like particles to serve as hemostats that also promote the biological wound healing response. Thus, we believe synthetic hydrogels are ideal candidates to address the clear need for better wound healing materials.
每年，过量出血（即大出血）导致数百万平民和非平民伤亡。此外，伤口后遗症，如感染，是慢性发病的重要来源，即使最初的出血成功止住。为了治疗急性和慢性伤口，人们已经鉴定、测试并采用了多种伤口愈合材料。其中包括局部敷料，如纱布，以及天然和仿生材料。然而，这些材料都无法成功模拟人体自身伤口愈合材料——血凝块——的复杂动态特性。具体而言，血凝块具有复杂的机械和生化特性，这些特性会随空间和时间尺度而变化，以引导伤口愈合反应，这使其成为理想的伤口愈合材料。在本手稿中，我们回顾了血凝块的复杂机械和生化特性，审视了当前的伤口愈合材料，并确定了新材料可提供额外功能的机会，特别关注水凝胶。我们强调了合成水凝胶的最新进展，这些进展使其能够模拟血凝块的更多特征：作为栓塞和组织修复的刺激物。我们得出结论，未来设计用于模拟血凝块生物化学、力学和结构的水凝胶材料可与令人兴奋的类血小板颗粒相结合，用作止血剂，同时促进生物伤口愈合反应。因此，我们认为合成水凝胶是满足对更好的伤口愈合材料明确需求的理想候选者。
